Research presented at the American Heart Association's EPI|Lifestyle Scientific Sessions 2026 suggests that where body fat is stored may be more critical for heart failure risk than overall weight. The study found that measurements indicating excess visceral fat around the waist were more strongly associated with heart failure risk than body mass index (BMI). Furthermore, systemic inflammation appears to mediate a significant portion of this relationship, accounting for approximately one-quarter to one-third of the link between central obesity and heart failure.
The analysis included health data for 1,998 African American adults from the Jackson Heart Study who did not have heart failure at enrollment. Over a median follow-up period of 6.9 years, 112 participants developed heart failure. Researchers assessed body fat using weight, BMI, waist circumference, and waist-to-height ratio. Blood samples were tested for high-sensitivity C-reactive protein, a marker of inflammation. The findings showed that elevated waist measurements were associated with increased heart failure risk, while high BMI was not. Participants with higher inflammation levels were also more likely to experience heart failure during the follow-up period.
"This research helps us understand why some people develop heart failure despite having a body weight that seems healthy," said Szu-Han Chen, the study's lead author. The implications are significant for preventive healthcare. Clinicians may be able to identify individuals at higher risk earlier by monitoring waist size and inflammation markers, allowing for targeted prevention strategies before heart failure symptoms begin. This aligns with a 2025 scientific statement from the American Heart Association, which identified systemic inflammation as a common risk factor for heart disease.
The study's focus on central adiposity—fat stored around the abdomen—highlights a potential shift in clinical practice. "This study highlights the importance of integrating measures of central adiposity such as waist circumference into routine preventive care," said Dr. Sadiya S. Khan, chair of the Association's 2025 risk statement. The American Heart Association has further emphasized the role of inflammation through initiatives like the Systemic Inflammation Data Challenge, aimed at deepening understanding of how inflammation contributes to heart conditions.
For the public, this research underscores that a normal BMI does not necessarily equate to low heart failure risk if excess weight is concentrated around the waist. The findings suggest that reducing inflammation could be a potential strategy to mitigate risk in individuals with central obesity. However, the researchers note limitations, including a lack of data on heart failure subtypes, and call for future studies to examine how visceral fat and inflammation relate to different types of heart failure and whether anti-inflammatory interventions can reduce risk. The abstract is part of the EPI|Lifestyle Scientific Sessions 2026 Online Program Planner.
